Payment Options

How Much Will it Cost to see Dr Puttaswamy

Sydney Vascular Surgery request that all payments for consultations be made on the day of the consultation and that you bring a current referral with you.

Our costs for consultations are as follows:

These items are rebateable from Medicare only when you see the doctor as an outpatient and have a current referral.

How Much Do I get back from Medicare?

The rebate amount will vary from time to time and will depend on whether you have reached the Medicare Safety-Net or not.

When you have paid your account we can submit your claim directly to Medicare (provided with have your Medicare number and a current referral) and we can then print the statement from Medicare which indicates what rebate you will get from them.

Why Do I need a referral if I have seen the doctor before?

It is a requirement of Medicare that in order for specialist consultations to be rebated patients require a current referral. You can see the doctor without a current referral but will not be able to claim from Medicare.

• Referrals from Specialists last for 3 months.
• Referrals from GPs last for 12 months, unless an “Indefinite” referral is provided, in which case the referral will, in theory, never expire.

How Much will my surgery/procedure cost?

It depends.

However, when you have a planned procedure we will do our utmost to provide you with an accurate quote of what the total cost for Sydney Vascular Surgery’s services will be, including an indication of how much you will be out-of-pocket. Sometimes we cannot predict what might happen on the day of your procedure and this can sometimes lead to changes in anticipated costs.

We will also provide you with contact details for anaesthetists and assistants so that you can contact them about their fees.

How Sydney Vascular Surgery Bills for Operations and Procedures

We know that understanding the why's and how's of doctors billing methods is not high on your list of priorities, but if you are contemplating surgery, we thought these basic principles might help shed some light.

How Does It Work?

Medicare designates an item number for all types of medical services (often more than one item is applicable for surgery). Medicare also determines the value of each item. The value, or fee, that they determine is appropriate is called the Schedule Fee. As you may have heard in the media, there has been no increase in the Schedule Fee for a number of years now and the forecast is that it will not change for many years to come.

When you receive services as a private patient in a hospital that have a Medicare item number/s, Medicare will pay 75% of the Schedule Fee and your Health Fund will pay 25% of the Schedule Fee for that service. The cost of staying in hospital as a private patient is not covered by Medicare at all, your Health Fund will pay for your stay in total (minus any excess you may have of course).

As you may have noticed the Schedule Fee is not usually what your doctor charges for surgery. The Australian Medical Association (AMA) has determined what they believe each Medicare item is worth, within the context of doctor expertise and the costs associated with running a practice etc, hence the AMA fee is usually greater than the Schedule Fee. Sydney Vascular Surgery uses the AMA fees as a guide in determining fees for surgery.

Having said all of that, we know that everyone's circumstances are different, so there are three ways that we might invoice you for your surgery, they are as follows:

Patient Invoiced Directly:

An invoice is issued directly to you for payment within 28 days. We will try really hard to let you know before your surgery what that invoice is going to look like and how much you will be out-of-pocket. Once you have paid, we will issue a receipt that you can use to claim from Medicare and your Health Fund. Easy.

Bill the Fund Directly:

Most Health Funds allow us to bill them directly for services provided, because we enter into an agreement with them. If we do that they will pay slightly more than the Schedule Fee (in conjunction with Medicare of course) and pay that money directly into our bank account. If we bill for a surgical service in this manner, our agreement with the Health Fund is that we cannot charge you anything out-of-pocket, so we don't.

We will invoice for services in this manner if re-treatment of an area is required within a short time period or at the surgeon's discretion, because even when billing like this, the fee is still much less than the AMA recommended fee and what we would normally charge.

Known-Gap

There are a few Health Funds that have a scheme that allows us to bill what is commonly called the "Known-Gap". The agreement with these Health Funds state that they (in conjunction with Medicare) will pay slightly higher rate than the Schedule Fee (just like above in Billing the Fund Directly) AND the surgeon can bill the patient an out-of-pocket amount that they determine. When we bill you this way, the health fund is invoiced directly and payment made by them to us, minus “Known Gap”. The "Known Gap" amount is then invoiced directly to you.

If we bill you in this manner, it is at the surgeons discretion, because even when billing like this, the fee is still much less than the AMA recommended fee and what we would normally charge. You will also need to be a member of a Health Fund that has a scheme like this one.

We hope this information was helpful. If you have more questions or you have any concerns about your surgical bill, feel free to call us on: (02) 9439-8715 or email us at: info@sydneyvascularsurgery.com.au.